Effects of Immunonutrition for Cystectomy on Immune Response and Infection Rates: A Pilot Randomized Controlled Clinical Trial.

Autor: Hamilton-Reeves JM; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: jhamilton-reeves@kumc.edu., Bechtel MD; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA., Hand LK; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA., Schleper A; Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA., Yankee TM; Department of Microbiology, Molecular Genetics, and Immunology, University of Kansas Medical Center, Kansas City, KS, USA., Chalise P; Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, USA., Lee EK; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA., Mirza M; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA., Wyre H; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA., Griffin J; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA., Holzbeierlein JM; Department of Urology, University of Kansas Medical Center, Kansas City, KS, USA.
Jazyk: angličtina
Zdroj: European urology [Eur Urol] 2016 Mar; Vol. 69 (3), pp. 389-92. Date of Electronic Publication: 2015 Nov 30.
DOI: 10.1016/j.eururo.2015.11.019
Abstrakt: Unlabelled: After radical cystectomy (RC), patients are at risk for complications including infections. The expansion of myeloid-derived suppressor cells (MDSCs) after surgery may contribute to the lower resistance to infection. Immune response and postoperative complications were compared in men consuming either specialized immunonutrition (SIM; n=14) or an oral nutrition supplement (ONS; n=15) before and after RC. MDSC count (Lin- CD11b+ CD33+) was significantly different between the groups over time (p=0.005) and significantly lower in SIM 2 d after RC (p<0.001). MDSC count expansion from surgery to 2 d after RC showed a weak association with an increase in infection rate 90 d after surgery (p=0.061). Neutrophil:lymphocyte ratio was significantly lower in SIM compared with ONS 3h after the first incision (p=0.039). Participants receiving SIM had a 33% reduction in postoperative complication rate (95% confidence interval [CI], 1-64; p=0.060) and a 39% reduction in infection rate (95% CI, 8-70; p=0.027) during late-phase recovery. The small sample size limits the study findings.
Patient Summary: Results show that the immune response to surgery and late infection rates differ between radical cystectomy patients receiving specialized immunonutrition versus oral nutrition supplement in the perioperative period.
Trial Registration: ClinicalTrials.gov NCT01868087.
(Copyright © 2015 European Association of Urology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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